|
IR TRANSL PERI ATHERECT PER TI
|
Facility
|
OP
|
$13,876.00
|
|
|
Service Code
|
HCPCS 35495
|
| Hospital Charge Code |
2680165
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$334.41 |
| Max. Negotiated Rate |
$6,938.00 |
| Rate for Payer: Aetna Commercial |
$5,272.88
|
| Rate for Payer: Aetna Medicare Advantage |
$4,162.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,538.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,538.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,626.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,538.38
|
| Rate for Payer: Cigna Commercial |
$6,938.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,162.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,081.40
|
| Rate for Payer: UnitedHealthcare Community & State |
$334.41
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$367.71
|
|
|
IR TRANSL PERIP ATHERECTOMY PE
|
Facility
|
IP
|
$11,101.00
|
|
|
Service Code
|
HCPCS 35493
|
| Hospital Charge Code |
2680160
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,665.15 |
| Max. Negotiated Rate |
$1,665.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,665.15
|
|
|
IR TRANSL PERIP ATHERECTOMY PE
|
Facility
|
OP
|
$11,101.00
|
|
|
Service Code
|
HCPCS 35493
|
| Hospital Charge Code |
2680160
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$267.53 |
| Max. Negotiated Rate |
$5,550.50 |
| Rate for Payer: Aetna Commercial |
$4,218.38
|
| Rate for Payer: Aetna Medicare Advantage |
$3,330.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,830.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,830.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,626.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,830.76
|
| Rate for Payer: Cigna Commercial |
$5,550.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,330.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,665.15
|
| Rate for Payer: UnitedHealthcare Community & State |
$267.53
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$294.18
|
|
|
IR TRANSRECTAL DRAIN PALVIC AB
|
Facility
|
OP
|
$10,145.56
|
|
|
Service Code
|
HCPCS 45000
|
| Hospital Charge Code |
2670175
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$244.51 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Aetna Commercial |
$3,866.86
|
| Rate for Payer: Aetna Medicare Advantage |
$4,606.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5,131.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5,131.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,421.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$862.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5,131.69
|
| Rate for Payer: Cigna Commercial |
$2,849.67
|
| Rate for Payer: Cigna Medicare Advantage |
$1,421.64
|
| Rate for Payer: Clover Medicare Advantage |
$1,350.56
|
| Rate for Payer: EmblemHealth Commercial |
$4,264.92
|
| Rate for Payer: Humana Medicare Advantage |
$1,464.29
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,421.64
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,043.67
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,521.83
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$244.51
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,421.64
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,421.64
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$268.86
|
|
|
IR TRANSRECTAL DRAIN PALVIC AB
|
Facility
|
IP
|
$10,145.56
|
|
|
Service Code
|
HCPCS 45000
|
| Hospital Charge Code |
7411552
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,521.83 |
| Max. Negotiated Rate |
$1,521.83 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,521.83
|
|
|
IR TRANSRECTAL DRAIN PALVIC AB
|
Facility
|
OP
|
$10,145.56
|
|
|
Service Code
|
HCPCS 45000
|
| Hospital Charge Code |
7411552
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$244.51 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Aetna Commercial |
$3,866.86
|
| Rate for Payer: Aetna Medicare Advantage |
$4,606.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5,131.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5,131.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,421.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$862.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5,131.69
|
| Rate for Payer: Cigna Commercial |
$2,849.67
|
| Rate for Payer: Cigna Medicare Advantage |
$1,421.64
|
| Rate for Payer: Clover Medicare Advantage |
$1,350.56
|
| Rate for Payer: EmblemHealth Commercial |
$4,264.92
|
| Rate for Payer: Humana Medicare Advantage |
$1,464.29
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,421.64
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,043.67
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,521.83
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$244.51
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,421.64
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,421.64
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$268.86
|
|
|
IR TRANSRECTAL DRAIN PALVIC AB
|
Facility
|
IP
|
$10,145.56
|
|
|
Service Code
|
HCPCS 45000
|
| Hospital Charge Code |
2670175
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,521.83 |
| Max. Negotiated Rate |
$1,521.83 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,521.83
|
|
|
IR TRLUML PERIP ATHRC BRCHIOCP
|
Facility
|
IP
|
$37,614.35
|
|
|
Service Code
|
HCPCS 0237T
|
| Hospital Charge Code |
7411855
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,642.15 |
| Max. Negotiated Rate |
$5,642.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,642.15
|
|
|
IR TRLUML PERIP ATHRC BRCHIOCP
|
Facility
|
IP
|
$37,614.35
|
|
|
Service Code
|
HCPCS 0237T
|
| Hospital Charge Code |
5600217
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,642.15 |
| Max. Negotiated Rate |
$5,642.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,642.15
|
|
|
IR TRLUML PERIP ATHRC BRCHIOCP
|
Facility
|
OP
|
$37,614.35
|
|
|
Service Code
|
HCPCS 0237T
|
| Hospital Charge Code |
5600217
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$906.51 |
| Max. Negotiated Rate |
$49,506.31 |
| Rate for Payer: Aetna Commercial |
$37,304.26
|
| Rate for Payer: Aetna Medicare Advantage |
$44,435.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$49,506.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$49,506.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$13,714.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,626.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$49,506.31
|
| Rate for Payer: Cigna Commercial |
$27,491.26
|
| Rate for Payer: Cigna Medicare Advantage |
$13,714.80
|
| Rate for Payer: Clover Medicare Advantage |
$13,029.06
|
| Rate for Payer: EmblemHealth Commercial |
$41,144.40
|
| Rate for Payer: Humana Medicare Advantage |
$14,126.24
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$13,714.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$11,284.31
|
| Rate for Payer: Oxford Commercial |
$9,689.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,642.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$16,605.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$906.51
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$13,714.80
|
| Rate for Payer: Wellcare Medicare Advantage |
$13,714.80
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$996.78
|
|
|
IR TRLUML PERIP ATHRC BRCHIOCP
|
Facility
|
OP
|
$37,614.35
|
|
|
Service Code
|
HCPCS 0237T
|
| Hospital Charge Code |
7411855
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$906.51 |
| Max. Negotiated Rate |
$49,506.31 |
| Rate for Payer: Aetna Commercial |
$37,304.26
|
| Rate for Payer: Aetna Medicare Advantage |
$44,435.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$49,506.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$49,506.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$13,714.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,626.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$49,506.31
|
| Rate for Payer: Cigna Commercial |
$27,491.26
|
| Rate for Payer: Cigna Medicare Advantage |
$13,714.80
|
| Rate for Payer: Clover Medicare Advantage |
$13,029.06
|
| Rate for Payer: EmblemHealth Commercial |
$41,144.40
|
| Rate for Payer: Humana Medicare Advantage |
$14,126.24
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$13,714.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$11,284.31
|
| Rate for Payer: Oxford Commercial |
$9,689.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,642.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$16,605.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$906.51
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$13,714.80
|
| Rate for Payer: Wellcare Medicare Advantage |
$13,714.80
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$996.78
|
|
|
IR TRLUML PERIP ATHRC ILIAC AR
|
Facility
|
OP
|
$80,096.45
|
|
|
Service Code
|
HCPCS 0238T
|
| Hospital Charge Code |
41100238T
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,626.00 |
| Max. Negotiated Rate |
$78,613.74 |
| Rate for Payer: Aetna Commercial |
$59,237.44
|
| Rate for Payer: Aetna Medicare Advantage |
$70,562.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$78,613.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$78,613.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$21,778.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,626.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$78,613.74
|
| Rate for Payer: Cigna Commercial |
$43,654.87
|
| Rate for Payer: Cigna Medicare Advantage |
$21,778.47
|
| Rate for Payer: Clover Medicare Advantage |
$20,689.55
|
| Rate for Payer: EmblemHealth Commercial |
$65,335.41
|
| Rate for Payer: Humana Medicare Advantage |
$22,431.82
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$21,778.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$24,028.94
|
| Rate for Payer: Oxford Commercial |
$9,689.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$12,014.47
|
| Rate for Payer: UnitedHealthcare Commercial |
$16,605.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,930.32
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$21,778.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$21,778.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2,122.56
|
|
|
IR TRLUML PERIP ATHRC ILIAC AR
|
Facility
|
OP
|
$37,614.35
|
|
|
Service Code
|
HCPCS 0238T
|
| Hospital Charge Code |
7411856
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$906.51 |
| Max. Negotiated Rate |
$78,613.74 |
| Rate for Payer: Aetna Commercial |
$59,237.44
|
| Rate for Payer: Aetna Medicare Advantage |
$70,562.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$78,613.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$78,613.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$21,778.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,626.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$78,613.74
|
| Rate for Payer: Cigna Commercial |
$43,654.87
|
| Rate for Payer: Cigna Medicare Advantage |
$21,778.47
|
| Rate for Payer: Clover Medicare Advantage |
$20,689.55
|
| Rate for Payer: EmblemHealth Commercial |
$65,335.41
|
| Rate for Payer: Humana Medicare Advantage |
$22,431.82
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$21,778.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$11,284.31
|
| Rate for Payer: Oxford Commercial |
$9,689.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,642.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$16,605.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$906.51
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$21,778.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$21,778.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$996.78
|
|
|
IR TRLUML PERIP ATHRC ILIAC AR
|
Facility
|
OP
|
$89,914.40
|
|
|
Service Code
|
HCPCS 0238T
|
| Hospital Charge Code |
32100238T
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,626.00 |
| Max. Negotiated Rate |
$78,613.74 |
| Rate for Payer: Aetna Commercial |
$59,237.44
|
| Rate for Payer: Aetna Medicare Advantage |
$70,562.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$78,613.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$78,613.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$21,778.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,626.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$78,613.74
|
| Rate for Payer: Cigna Commercial |
$43,654.87
|
| Rate for Payer: Cigna Medicare Advantage |
$21,778.47
|
| Rate for Payer: Clover Medicare Advantage |
$20,689.55
|
| Rate for Payer: EmblemHealth Commercial |
$65,335.41
|
| Rate for Payer: Humana Medicare Advantage |
$22,431.82
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$21,778.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$26,974.32
|
| Rate for Payer: Oxford Commercial |
$9,689.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13,487.16
|
| Rate for Payer: UnitedHealthcare Commercial |
$16,605.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$2,166.94
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$21,778.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$21,778.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2,382.73
|
|
|
IR TRLUML PERIP ATHRC ILIAC AR
|
Facility
|
IP
|
$80,096.45
|
|
|
Service Code
|
HCPCS 0238T
|
| Hospital Charge Code |
41100238T
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$12,014.47 |
| Max. Negotiated Rate |
$12,014.47 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$12,014.47
|
|
|
IR TRLUML PERIP ATHRC ILIAC AR
|
Facility
|
IP
|
$89,914.40
|
|
|
Service Code
|
HCPCS 0238T
|
| Hospital Charge Code |
5600219
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$13,487.16 |
| Max. Negotiated Rate |
$13,487.16 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$13,487.16
|
|
|
IR TRLUML PERIP ATHRC ILIAC AR
|
Facility
|
IP
|
$37,614.35
|
|
|
Service Code
|
HCPCS 0238T
|
| Hospital Charge Code |
7411856
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,642.15 |
| Max. Negotiated Rate |
$5,642.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,642.15
|
|
|
IR TRLUML PERIP ATHRC ILIAC AR
|
Facility
|
IP
|
$80,096.45
|
|
|
Service Code
|
HCPCS 0238T
|
| Hospital Charge Code |
36680238T
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$12,014.47 |
| Max. Negotiated Rate |
$12,014.47 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$12,014.47
|
|
|
IR TRLUML PERIP ATHRC ILIAC AR
|
Facility
|
OP
|
$80,096.45
|
|
|
Service Code
|
HCPCS 0238T
|
| Hospital Charge Code |
36680238T
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,626.00 |
| Max. Negotiated Rate |
$78,613.74 |
| Rate for Payer: Aetna Commercial |
$59,237.44
|
| Rate for Payer: Aetna Medicare Advantage |
$70,562.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$78,613.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$78,613.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$21,778.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,626.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$78,613.74
|
| Rate for Payer: Cigna Commercial |
$43,654.87
|
| Rate for Payer: Cigna Medicare Advantage |
$21,778.47
|
| Rate for Payer: Clover Medicare Advantage |
$20,689.55
|
| Rate for Payer: EmblemHealth Commercial |
$65,335.41
|
| Rate for Payer: Humana Medicare Advantage |
$22,431.82
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$21,778.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$24,028.94
|
| Rate for Payer: Oxford Commercial |
$9,689.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$12,014.47
|
| Rate for Payer: UnitedHealthcare Commercial |
$16,605.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,930.32
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$21,778.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$21,778.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2,122.56
|
|
|
IR TRLUML PERIP ATHRC ILIAC AR
|
Facility
|
IP
|
$89,914.40
|
|
|
Service Code
|
HCPCS 0238T
|
| Hospital Charge Code |
32100238T
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$13,487.16 |
| Max. Negotiated Rate |
$13,487.16 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$13,487.16
|
|
|
IR TRLUML PERIP ATHRC ILIAC AR
|
Facility
|
OP
|
$89,914.40
|
|
|
Service Code
|
HCPCS 0238T
|
| Hospital Charge Code |
5600219
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,626.00 |
| Max. Negotiated Rate |
$78,613.74 |
| Rate for Payer: Aetna Commercial |
$59,237.44
|
| Rate for Payer: Aetna Medicare Advantage |
$70,562.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$78,613.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$78,613.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$21,778.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,626.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$78,613.74
|
| Rate for Payer: Cigna Commercial |
$43,654.87
|
| Rate for Payer: Cigna Medicare Advantage |
$21,778.47
|
| Rate for Payer: Clover Medicare Advantage |
$20,689.55
|
| Rate for Payer: EmblemHealth Commercial |
$65,335.41
|
| Rate for Payer: Humana Medicare Advantage |
$22,431.82
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$21,778.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$26,974.32
|
| Rate for Payer: Oxford Commercial |
$9,689.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13,487.16
|
| Rate for Payer: UnitedHealthcare Commercial |
$16,605.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$2,166.94
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$21,778.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$21,778.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2,382.73
|
|
|
IR TRLUML PERIP ATHRC RENAL AR
|
Facility
|
IP
|
$37,914.35
|
|
|
Service Code
|
HCPCS 0234T
|
| Hospital Charge Code |
5600218
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,687.15 |
| Max. Negotiated Rate |
$5,687.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,687.15
|
|
|
IR TRLUML PERIP ATHRC RENAL AR
|
Facility
|
IP
|
$37,614.35
|
|
|
Service Code
|
HCPCS 0234T
|
| Hospital Charge Code |
7411848
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,642.15 |
| Max. Negotiated Rate |
$5,642.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,642.15
|
|
|
IR TRLUML PERIP ATHRC RENAL AR
|
Facility
|
OP
|
$37,614.35
|
|
|
Service Code
|
HCPCS 0234T
|
| Hospital Charge Code |
7411848
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$906.51 |
| Max. Negotiated Rate |
$49,506.31 |
| Rate for Payer: Aetna Commercial |
$37,304.26
|
| Rate for Payer: Aetna Medicare Advantage |
$44,435.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$49,506.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$49,506.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$13,714.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,626.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$49,506.31
|
| Rate for Payer: Cigna Commercial |
$27,491.26
|
| Rate for Payer: Cigna Medicare Advantage |
$13,714.80
|
| Rate for Payer: Clover Medicare Advantage |
$13,029.06
|
| Rate for Payer: EmblemHealth Commercial |
$41,144.40
|
| Rate for Payer: Humana Medicare Advantage |
$14,126.24
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$13,714.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$11,284.31
|
| Rate for Payer: Oxford Commercial |
$9,689.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,642.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$16,605.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$906.51
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$13,714.80
|
| Rate for Payer: Wellcare Medicare Advantage |
$13,714.80
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$996.78
|
|
|
IR TRLUML PERIP ATHRC RENAL AR
|
Facility
|
OP
|
$37,914.35
|
|
|
Service Code
|
HCPCS 0234T
|
| Hospital Charge Code |
5600218
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$913.74 |
| Max. Negotiated Rate |
$49,506.31 |
| Rate for Payer: Aetna Commercial |
$37,304.26
|
| Rate for Payer: Aetna Medicare Advantage |
$44,435.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$49,506.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$49,506.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$13,714.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,626.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$49,506.31
|
| Rate for Payer: Cigna Commercial |
$27,491.26
|
| Rate for Payer: Cigna Medicare Advantage |
$13,714.80
|
| Rate for Payer: Clover Medicare Advantage |
$13,029.06
|
| Rate for Payer: EmblemHealth Commercial |
$41,144.40
|
| Rate for Payer: Humana Medicare Advantage |
$14,126.24
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$13,714.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$11,374.31
|
| Rate for Payer: Oxford Commercial |
$9,689.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,687.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$16,605.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$913.74
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$13,714.80
|
| Rate for Payer: Wellcare Medicare Advantage |
$13,714.80
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1,004.73
|
|
